Enhanced patient reported outcome measurement suitable for head and neck cancer follow-up clinics
Identifieur interne : 003314 ( Main/Exploration ); précédent : 003313; suivant : 003315Enhanced patient reported outcome measurement suitable for head and neck cancer follow-up clinics
Auteurs : Naseem Ghazali [Royaume-Uni] ; Derek Lowe [Royaume-Uni] ; Simon N. Rogers [Royaume-Uni]Source :
- Head & Neck Oncology [ 1758-3284 ] ; 2012.
Abstract
The ‘Worse-Stable-Better’ (W-S-B) question was introduced to capture patient-perceived change in University of Washington Quality of Life (UW-QOL) domains.
202 head and neck cancer patients in remission prospectively completed UW-QOL and Patients Concerns Inventory (PCI). For each UW-QOL domain, patients indicated whether over the last month things had worsened (W), remained stable (S) or were better (B).
202 patients at 448 attendances selected 1752 PCI items they wanted to discuss in consultation, and 58% (1024/1752) of these were not covered by the UW-QOL. UW-QOL algorithms highlighted another 440 significant problems that the patient did not want to discuss (i.e. the corresponding items on the PCI were not selected).
After making allowance for UW-QOL algorithms to identify 'significant problems' and PCI selection of corresponding issues for discussion there remained clear residual and notable variation in W-S-B responses, in particular to identify patients with significant problems that were getting worse, and patients without significant problems that wanted to discuss issues that were getting worse. Changes in mean UW-QOL scores were notably lower for those getting worse on the W-S-B question, typically by 10 or more units a magnitude that suggests clinically important changes in score.
The W-S-B question adds little questionnaire burden and could help to better identify patients who might benefit from intervention. The results of this study suggest that the UW-QOL with the W-S-B modification should be used together with the PCI to allow optimal identification of issues for patient-clinician discussion during routine outpatient clinics.
Url:
DOI: 10.1186/1758-3284-4-32
PubMed: 22695251
PubMed Central: 3448513
Affiliations:
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Rogers</name><affiliation wicri:level="1"><nlm:aff id="I1">Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE</wicri:regionArea><wicri:noRegion>L9 1AE</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, St Helens Road, Ormskirk, L39 4QP</wicri:regionArea><wicri:noRegion>L39 4QP</wicri:noRegion></affiliation></author></analytic><series><title level="j">Head & Neck Oncology</title><idno type="eISSN">1758-3284</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The ‘Worse-Stable-Better’ (W-S-B) question was introduced to capture patient-perceived change in University of Washington Quality of Life (UW-QOL) domains.</p></sec><sec><title>Methods</title><p>202 head and neck cancer patients in remission prospectively completed UW-QOL and Patients Concerns Inventory (PCI). For each UW-QOL domain, patients indicated whether over the last month things had worsened (W), remained stable (S) or were better (B).</p></sec><sec><title>Results</title><p>202 patients at 448 attendances selected 1752 PCI items they wanted to discuss in consultation, and 58% (1024/1752) of these were not covered by the UW-QOL. UW-QOL algorithms highlighted another 440 significant problems that the patient did not want to discuss (i.e. the corresponding items on the PCI were not selected).</p><p>After making allowance for UW-QOL algorithms to identify 'significant problems' and PCI selection of corresponding issues for discussion there remained clear residual and notable variation in W-S-B responses, in particular to identify patients with significant problems that were getting worse, and patients without significant problems that wanted to discuss issues that were getting worse. Changes in mean UW-QOL scores were notably lower for those getting worse on the W-S-B question, typically by 10 or more units a magnitude that suggests clinically important changes in score.</p></sec><sec><title>Conclusions</title><p>The W-S-B question adds little questionnaire burden and could help to better identify patients who might benefit from intervention. The results of this study suggest that the UW-QOL with the W-S-B modification should be used together with the PCI to allow optimal identification of issues for patient-clinician discussion during routine outpatient clinics.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Epstein, Rm" uniqKey="Epstein R">RM Epstein</name></author><author><name sortKey="Street, Rl" uniqKey="Street R">RL Street</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Low, C" uniqKey="Low C">C Low</name></author><author><name sortKey="Fullarton, M" uniqKey="Fullarton M">M Fullarton</name></author><author><name sortKey="Parkinson, E" uniqKey="Parkinson E">E Parkinson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rogers, Sn" uniqKey="Rogers S">SN Rogers</name></author><author><name sortKey="Mcnally, D" uniqKey="Mcnally D">D McNally</name></author><author><name sortKey="Mahmood, M" 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